According to reports published from AthenaHealth, billing professionals in the provider’s office
only collect patient dues 12% of the time. Given the high rising deductibles in the evolved
insurance plans, it is now clear that the greater responsibility of the medical bills falls on the
patients. The economic downfall in recent times, along with the high medical co-pays, is making it
even more difficult for the provider’s office to collect their due payment from the patients. A
leading RCM company understands these specific pain points of the medical billing ecosystem and can
help you with a way out.
Statistical Insights on Collection Status
Most healthcare organizations track their revenue integrity with the help of the cash flow getting
into the system in exchange for their services. The collection rate is one such key performance
indicator that helps to determine the health status of the organization’s financial management.
According to research and surveys, most healthcare providers lose out on their due revenue in the
form of overdue payments from the patients.
The trends in patient collections indicate that you have a higher chance of getting paid if your
overdue payments are lesser or equal to $35.
As the value of the overdue starts to rise, the chances of getting paid start to drop. For example,
the collection rate dropped to 6% when the outstanding amount went over $200.
73% of the outstanding dues in a typical provider’s office go above $200, making it more difficult
to retrieve, thus slowing down the revenue flow.
Two out of three providers left the money on the table when the patients did not pay outstanding
dues amounting to $200 or more within a year.
The statistics do not look very promising as far as the revenue health of the healthcare
organizations is concerned. The trends strongly suggest that you improve the workflow for maximizing
your collection rates. Know how an RCM company can help you achieve your goals.
Establish Transparent Communication
Survey reports from patient experiences indicate that they look for
transparent payment objectives
before deciding on getting a medical service or a particular healthcare system. While
machine-readable files show a fair estimate of the price, the actual billing can only take place
after considering all the associated services. Experts suggest that it is crucial for healthcare
organizations to train their front-end office staff to communicate these details with the patient. A
healthy and transparent dialogue between the patient and the provider’s office at the beginning of
their journey will lay the foundation of trust and goodwill.
During these conversations, the front-end office staff should
consider the various data points of the patient’s account
like their insurance details, covered services, and any need for financial assistance. The RCM
company taking care of your patient collections can use the data to take the conversation further.
The first step towards a good collection strategy significantly lies in the approach of the in-house
staff. However, the trained professionals at the RCM company are proficient in handling the
different scenarios that might arise during the actual collection process.
Analyze the Patient’s Account
Knowing the patient’s account in depth is critical to getting the future collections on time and
without any disruption. An RCM company handling the patient eligibility verification process takes
the patient’s demographic details and checks the insurance details to understand which services the
insurance will cover. Since most patients are enrolled in high-deductible insurance plans, it is
crucial to set up a formal reminder or scheduler system.
The RCM company can also enquire if the patient has an HSA or flexible spending account, which helps
in the easy self-pay options for the patients. EHR integration with the billing workflow can keep
the entire revenue cycle management team in a loop and notify the front-end staff of an outstanding
payment for the patients when they log into their accounts. Leading RCM companies use advanced
software solutions to keep the workflow in good shape.
Versatile Payment Options
Introducing a range of payment options for the patients can ease their burden and make sure that you
get your payment on time. Most healthcare billing professionals save the patient’s payment card
information in their file, especially in the case of insurance plans with a high deductible. This
way, they can deduct the money automatically while submitting the claim. However, not all patients
will agree to this system.
The team from your partner RCM company will set up a schedule to call the patients at regular
intervals to collect the payments in time. During this process, it is crucial to remember that the
team should align communication guidelines with the patient experience goal of your organization.
Installments and recurring subscription payments could be a great way to achieve your collection
goals. RCM companies can also maintain the financial services guidelines for the patient accounts
and establish professional communication with the payer in question.
Communication Best Practices
RCM companies handling patient collection procedures train their professionals to ensure that the
outgoing calls to the patients comply with your organizational guidelines. They also maintain
separate scripts for the different scenarios to ensure they collect the amount without hampering the
patient’s relationship with the provider’s office.
Handling real-life patient calls can be challenging. While some patients might forget to pay the due
amount in the absence of a reminder, some patients might have some financial difficulties at the
moment to pay the entire bill. In some other cases, patients might refuse to pay the bills due to a
wrong entry or any misunderstanding of the items noted. Professionals in any leading RCM company
know how to identify the issue during the call and resolve the problem with a short turn-around
time. They follow the goal of receiving the payment during the call or initiating the electronic
payment to close the account. If the patient needs financial assistance, they can forward the call
to the assigned executive in your in-house team.
We hope this article helped you understand how an RCM company can help you maximize patient
collections with a successful working model. Please connect with us in the comment section below in
case of any queries. Subscribe to our blog for regular articles on the medical billing industry.
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